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Download the registration form PMB July 2022
Download the registration form 15 July 2022

Disrupting Prescribed Minimum Benefits (PMBs) 2022


Delegates will gain an understanding of

·         The fundamentals of the prescribed minimum benefits, how to interpret and apply them.

·         What should be included in the PMB basket of care, and how schemes can manage the associated risk.

·         What is proposed as reforms

·         Lessons to be learnt from the Council for Medical Schemes Judgements on Appeals


This event will be hosted via the Teams Microsoft platform

Programme:

Group 1 - 28 & 29 June 2022 - FULLY BOOKED

Group 2 - 12 & 13 July 2022

First day 09:00 to 13:00 –

·         Rationale for the introduction of the PMBs

·         What are the PMBs and the entitlement to benefits

o    Diagnosis & Treatment Pairs

o    Emergency Condition

o    Chronic Disease List

·         Review of the Council for Medical Schemes Judgements on Appeals – Lessons to be learnt

 

Second day 09:00 to 13:00 –

·         Risk management

o    Role of benefit design and managed care

·         PMB Code of Conduct  2017

·         Review of the Council for Medical Schemes Judgements on Appeals – Lessons to be learnt

·         Proposed changes to the legislation governing  PMBs

o    Health Market Inquiry Recommendation

o    Council for Medical Schemes

" How can the private health sector implement some of the recommendations of the HMI Report?” 


Presenter: Dr Deborah Pearmain

Who will share her insights on this topic that has been on our minds since the publication of the Report. 


Date: 15 July 2022 from 09:00 to 11:00

Cost: R332.25 VAT incl per delegate


Dr Pearmain will be speaking on what the private health sector can do to try and ensure its survival in light of the Health Market Inquiry Report. 
 
She will include the following issues as raised in the report -

- Innovation and development of health service delivery models such as multidisciplinary practices or networks. I will touch on the HPCSA’s proposed new ethical rules in this regard which have just been published for public comment

- HPCSA must make it mandatory for all health practitioners to have training to ensure that graduates are aware of the cost implications of their decisions.

- Reduction of supply induced demand through overservicing and abuse of medical scheme benefits. The HMI said it found that utilisation rates were higher than can be explained by the burden of disease of the population being cared for.

- Improving relationships between medical schemes and providers and changing attitudes to each other - collaboration as opposed to antagonism - for the benefit of patients. e.g. keeping patients out of hospital through improved primary health care delivery.

- Reducing information asymmetry through improved communication with patients/members by medical schemes and providers, transparency in fee structures etc.

FSCA CPD Points - TBA

This event will be hosted via the Teams Microsoft platform

Dr Deborah Pearmain has worked in the healthcare industry for over 20 years. She has a BA LLB from Wits and a LLB in health law from the university of Pretoria.